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2025 NGN ATI COMMUNITY HEALTH PROCTORED EXAM FORM A, B, C, EXAM QUESTIONS AND ANSWERS, Exams of Nursing

University of Southern Indiana (USI)Nursing

1. During a home health visit a school age child who has muscular dystrophy confides in the nurse that he was struck by his parents. which of the following actions should the nurse take first? This question involves a school age child with muscular dystrophy who confides in a home health nurse that he was struck by his parents. As mandated reporters of child abuse and neglect, nurses have an ethical and legal obligation to report suspected maltreatment of a child. The priority is to ensure the immediate safety and well-being of the child. Therefore, the first action the nurse should take is to check the child for any injuries that may require medical attention. This allows the nurse to provide any necessary treatment while also documenting physical evidence of the reported abuse.

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2024/2025

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2025 NGN ATI COMMUNITY HEALTH

PROCTORED EXAM FORM A, B, C, EXAM

QUESTIONS AND ANSWERS

1. During a home health visit a school age child who has muscular dystrophy

confides in the

nurse that he was struck by his parents. which of the following actions should

the nurse

take first?

This question involves a school age child with muscular dystrophy who confides

in a home health nurse that he was struck by his parents. As mandated

reporters of child abuse and neglect, nurses have an ethical and legal obligation

to report suspected maltreatment of a child.

The priority is to ensure the immediate safety and well-being of the child.

Therefore, the first action the nurse should take is to check the child for any

injuries that may require medical attention. This allows the nurse to provide any

necessary treatment while also documenting physical evidence of the reported

abuse.

Of the answer options provided, "check the child for injuries" is the most

appropriate and prudent first step for the nurse to take. Reporting the incident

to authorities, referring the parents to services, and recommending anger

management classes are reasonable subsequent actions, but checking the

child's immediate medical status takes precedence.

Therefore, the best answer choice for the question is option 2 - "check the child

for injuries".

2. The nurse is planning a program to promote healthy eating among

elementary school students who typically choose unhealthy options like French

Partial preview of the text

Download 2025 NGN ATI COMMUNITY HEALTH PROCTORED EXAM FORM A, B, C, EXAM QUESTIONS AND ANSWERS and more Exams Nursing in PDF only on Docsity!

2025 NGN ATI COMMUNITY HEALTH

PROCTORED EXAM FORM A, B, C, EXAM

QUESTIONS AND ANSWERS

During a home health visit a school age child who has muscular dystrophy confides in the nurse that he was struck by his parents. which of the following actions should the nurse take first? This question involves a school age child with muscular dystrophy who confides in a home health nurse that he was struck by his parents. As mandated reporters of child abuse and neglect, nurses have an ethical and legal obligation to report suspected maltreatment of a child. The priority is to ensure the immediate safety and well-being of the child. Therefore, the first action the nurse should take is to check the child for any injuries that may require medical attention. This allows the nurse to provide any necessary treatment while also documenting physical evidence of the reported abuse. Of the answer options provided, "check the child for injuries" is the most appropriate and prudent first step for the nurse to take. Reporting the incident to authorities, referring the parents to services, and recommending anger management classes are reasonable subsequent actions, but checking the child's immediate medical status takes precedence. Therefore, the best answer choice for the question is option 2 - "check the child for injuries".
The nurse is planning a program to promote healthy eating among elementary school students who typically choose unhealthy options like French

fries and pizza for lunch. The first action the nurse should take is option 4 - "determine student's motivation to learn about healthy food choices." Here is the rationale: Before designing an educational program, it's important to assess the learners' readiness to receive the information. Determining the students' motivation and interest level in learning about nutrition will help the nurse know how to best tailor the program. This step comes before providing resources, giving feedback, or trying to convince the students of the importance of healthy eating. Once the nurse understands what motivates the students, what information they already know, and where their gaps lie, appropriate next steps would be providing helpful resources (option 3), giving positive feedback for good choices (option 1), and explaining the benefits of nutrition (option 2). But the initial needs assessment is key to planning an effective program. Assessing motivation first allows the nurse to develop a nutrtion program that will truly resonate with these students. Therefore, option 4 is the best first step in this situation. √√4. determine student's motivation to learn about healthy food choices.

a nurse manger in local community health agency is creating a job description for a new nurse who will practice community oriented nursing. which of the following should the nurse include in the job description? (select all that apply) Based on the information provided, the nurse manager is creating a job description for a community oriented nursing role. Some key responsibilities of a community health nurse that should be included are:

Investigate potential health and environmental issues - Correct. Assessing and identifying health issues affecting the community is an important role of community oriented nursing practice.

Clients will schedule bone density screening Rationale: Bone density screening is an important preventative measure for postmenopausal women who are at higher risk for osteoporosis. An appropriate outcome is for the nurse's education to motivate attendees to schedule this screening.
Clients will arrange for mammograms every 3 years This is a standard recommendation for women in this age group regardless of menopause status, so it is not the most relevant outcome specific to this audience.
Clients will start hormone replacement therapy The nurse should educate women about this option but not directly encourage starting HRT, which is an individual medical decision.
Clients will significantly decrease caloric intake While nutrition is important, there is no indication these clients need significant caloric reduction. This focuses too narrowly on just one health behavior change. In summary, option 1 - "Clients will schedule bone density screening" - is the most realistic and relevant expected outcome resulting from the nurse's planned educational program for postmenopausal women. The goal is influencing behaviors tied directly to this distinct health risk group.
a nurse is working with a care manager for a client who participates in a health maintenance organization. the nurse should identify that a health maintenance organization provides which of the following payment structures.
the client is participating in a fee for service health care insurance program
the provider is paid a fixed sum for the client on a monthly or yearly basis

the client pays the insurer a percentage of the total costs for each service rendered by the provider
the provider bills the client directly for a predetermined percentage of the cost of services – The correct payment structure for a health maintenance organization (HMO) is:
The provider is paid a fixed sum for the client on a monthly or yearly basis. Explanation: A health maintenance organization, or HMO, pays the healthcare providers that are in its network a fixed, prepaid amount per member per month. This is called capitation. This means that for each HMO member, the provider receives an upfront, flat fee to care for that patient. This is in contrast to a fee-for-service model in which providers bill services per treatment, test, or visit. Therefore, the payment structure in which "the provider is paid a fixed sum for the client on a monthly or yearly basis" is the defining structure of an HMO health insurance plan. This corresponds to option 2. Options 1, 3, and 4 describe other types of health insurance approaches like indemnity plans or discounted fee schedules. But option 2 best reflects a health maintenance organization's prepayment system.
a client who has diabetes mellitus asks a home health nurse to help her adapt some of her traditional cultural foods to fit her meal plan. which of the following is the first action the nurse should take when assisting this client?
provide the client with a printed recipe
observe the client during preparation of traditional foods
use cookbooks to include traditional foods in meal plans
explain diabetes exchange list – The first action the nurse should take when assisting this client is to observe the client during preparation of traditional foods.

MRSA is a contagious antibiotic-resistant bacterial infection. To prevent its spread, standard precautions should be taken when handling contaminated items from an infected client. Double bagging soiled dressings contains the bacteria and prevents transmission through contact. Wearing a mask is needed only during procedures likely to generate splash or sprays of bodily fluids. HEPA filters and removing flowers are not required special precautions for MRSA. Among the options, only “double bag soiled dressings in polyethylene bags” describes the appropriate handling of contaminated materials from a client with MRSA. This controls infection transmission risk. Therefore, option 4 is the correct nursing action to take when visiting a home health client with methicillin-resistant Staphylococcus aureus. Special bagging of contaminated dressings is the priority intervention.

an occupational health nurse is discussing health promotion with a client who has a history of obesity. which of the following comments indicates the client is using rationalization as a coping mechanism?
i have lots of health problems from being obese
I am obese it's in my genes
i have difficulty resisting the items in vending machines
i know you don't like me because i am obese – √√The comment by the client that indicates the use of rationalization as a coping mechanism is: "I am obese it's in my genes." Rationalization involves making excuses to justify attitudes, behaviors or situations instead of taking responsibility. By attributing the obesity solely to genetics/heredity, the client is rationalizing the condition rather than acknowledging any lifestyle habits that may also be contributing factors. The other statements do not qualify as rationalization coping mechanisms:

Acknowledges health effects of obesity
Describes a struggle to resist certain temptations
Expresses feeling that the nurse dislikes them So of all the answer choices, option 2 exhibits rationalization and blame shifting as a way of coping with obesity rather than owning personal behaviors that could help change the situation. Saying "I am obese it's in my genes" rationalizes the problem as completely outside the client's control, rather than looking inward at dietary or activity habits under their influence. This represents a rationalization coping mechanism.
a nurse is conducting a community assessment. which of the following information should the nurse include as part of the windshield survey?
demographic data
mortality rate
informant interviews
housing quality
- √√ The information that should be included in a windshield survey as part of a community assessment is the observation of housing quality. A windshield survey involves driving through and observing the community to gather visual data on conditions. Documentation of direct observations like the quality, condition, safety etc. of an area’s housing would be an appropriate part of this survey. Demographic data, mortality rates, and informant interviews would be gathered through other methods in a community assessment, not through direct windshield observation. Therefore, option 4 “housing quality” is the piece of information that aligns with what should actually be recorded while conducting a specific windshield survey.

a client who has superficial partial thickness burn injuries over 5% of his body
a client who has a femur fracture with a 2+ pedal pulse
a client who is ambulatory and exhibits manic behavior
a client who has a rigid abdomen with manifestations of shock.

√√ Based on the information provided, the client who should receive the highest priority for treatment by the triage nurse is the one with a rigid abdomen and manifestations of shock (option 4). Rationale: Triage refers to the assignment of treatment priority based on the severity of a patient's condition. In a mass casualty event with limited resources, the goal of triage is to do the greatest good for the greatest number and save as many lives as possible. The client with a rigid abdomen and signs of shock (option 4) indicates likely severe internal bleeding and a critical threat to life if not addressed immediately. This patient would be assigned the highest acuity level in an emergency triage system. The other clients have serious injuries, but are more stable:
Superficial burns (option 1) are less urgent than internal bleeding
A femur fracture (option 2) is serious but pulse indicates blood flow
The ambulatory client with manic behavior (option 3) can wait for behavioral assessment So the rigid abdomen with shock is the most time-sensitive, life-threatening condition requiring immediate intervention by the triage nurse. Prioritization of this patient gives the greatest chance for survival in a resource-limited mass casualty event.

a nurse is working with a community health care team to devise strategies for preventing violence in the community. which of the following interventions is an example of tertiary prevention?

presenting community education programs about stress management
developing resources for victims of abuse
urging community leaders to make nonviolence a priority
assessing for risk factors of intimate partner abuse during health examinations - √√ 2. developing resources for victims of abuse Tertiary prevention focuses on helping people manage complications and injuries after a disease or event has occurred. It aims to soften the impact of the disease or injury. Developing resources to help victims of abuse would be considered tertiary prevention of violence.
Presenting stress management education programs is primary prevention - trying to prevent violence before it occurs.
Urging leaders to prioritize nonviolence is primary prevention.
Assessing for risk factors of intimate partner abuse is secondary prevention - trying to detect violence early. So out of the options, #2 - developing resources for victims of abuse after violence has occurred - is tertiary prevention. It aims to minimize the ill effects after a violent event.
public health nurse take
alert the family members of coworkers about possible exposure to anthrax
place the employee under quarantine for 14 days
refer coworkers who might have been exposed to a provider for prophylactic antibiotics
instruct the client to wear a mask at work

√√3. refer coworkers who might have been exposed to a provider for prophylactic antibiotics If an employee is suspected of having anthrax infection, the public health nurse should focus on preventing disease in coworkers who may have been exposed.

Increased appetite is not a characteristic of alcohol withdrawal. Often, nausea and vomiting are noted instead.
Insomnia - yes. The CNS and autonomic excitement caused by alcohol withdrawal commonly lead to insomnia and an inability to sleep. Of the options, insomnia is the best example of a manifestation of alcohol withdrawal that the nurse should include in teaching.
a nurse is caring for a client who is homeless. which of the following actions should the nurse take first?
determine the clients understanding of her living situation
assist the client to develop goals for obtaining shelter
discuss the risks of being homeless with the client
develop client teaching using a variety of strategies
- √√ The nurse should first determine the client's understanding of her living situation (option 1). When caring for a client experiencing homelessness, it is important to avoid making assumptions and first understand the client’s unique perspective and feelings regarding their situation. Determining the client’s health literacy and insight is an essential first step before taking further actions to assist. Options 2-4 may be appropriate but should come after understanding where the client is at currently in relation to comprehension and acceptance of their homeless state. Taking action without understanding the client’s viewpoint risks causing defensiveness. Meeting the client where they are at empowers effective interventions. Establishing this understanding should be the nurse's priority initial action. Option 1 demonstratessensitivity to the client's health literacy and aims to support trust - the foundation of the nurse-client relationship.
a community health nurse observes the accumulation of garbage at a neighborhood playground. which of the following actions should the nurse take first to promote a clean and safe environment?

meet with community members to discuss methods of playground maintenance
partner city officials with community members to improve the playground condition
work with local businesses to sponsor more trash receptacles in the playground
engage neighborhood families to monitor the playground for further trash buildup

√√ The nurse should first meet with community members to discuss methods of playground maintenance (option 1). When addressing a community health issue, it is important for the nurse to collaborate directly with community members as the first step. Engaging the families and individuals actually affected in the discussion ensures the development of solutions that genuinely meet the community's needs and gains their buy-in. Beginning with community conversations enables strengths and challenges to be identified from the perspective of those closest to the issue, which guides effective next steps. The other options for partnership, sponsorship and engagement should follow the foundational step of eliciting the community's own views and priorities first. Option 1 emphasizes community-based participation and action, which are essential public health nursing values. Meeting first with neighborhood families fosters community empowerment and self-determination to drive changes that promote public wellbeing. This makes option 1 the priority first action.

a nurse in a mobile health clinic is caring for a client who requires a tetanus immunization and is accompanied by his daughter. the client does not speak the same language as the nurse. which of the following actions should the nurse take?
have the client's daughter communicate information about the procedure
arrange for a member of the client's community to interpret the teaching
identify the clients spoken dialect prior to contacting an interpreter

Chlamydia is a common sexually transmitted infection that can cause serious health complications if left untreated. Reporting chlamydia infections to public health authorities allows for monitoring of epidemiologic trends as well as enabling partner notification and community-level interventions. Herpes simplex virus (HSV), group B strep, and human papillomavirus (HPV) are not mandatorily reportable diseases in most public health jurisdictions. While important, they lack the combination of infectiousness, severity, and preventability that typically warrants legally mandated reporting to track incidence. So out of the answer options, chlamydia is the infection that the nurse should report to the state health department from a local clinic setting. Surveillance through mandatory reporting allows chlamydia to be tracked as a population health priority.

a clinic nurse is assessing a client who has measles. which of the following findings should the nurse expect?
koplik spots inside the mouth
persistent low grade temperature
muscle aches and tenderness
rash confined to the trunk of the body

√√The nurse should expect to find Koplik spots inside the mouth of a client with measles (option 1). Koplik spots refer to tiny blueish-white spots on a red background which appear on the inner mucosal lining of the mouth in the early stages of measles infection, just before the characteristic skin rash develops. Koplik spots are considered pathognomonic of measles. While fever may occur early on, measles more typically presents with a pronounced raised temperature rather than persistent low grade fever (option 2). Muscle aches can happen but are not a predominate measles symptom

(option 3). The red blotchy rash starts on the face and spreads down the body, rather than confined to the trunk alone (option 4). Thus Koplik spots inside the mouth are the most distinctive clinical marker to expect when a nurse is assessing someone with suspected measles. Noticing this finding can lead to early diagnosis and prevention of further transmission.

a community health nurse is planning a program for adolescents about preventing STIs. which of the following actions should the nurse take first?
collect data to identify barriers to learning
establish methods to evaluate program outcomes
obtain visual aids that feature adolescents
provide computer based education
- √√The nurse should first collect data to identify barriers to learning (option 1). When planning a community education program, the priority initial step is to assess the needs and barriers of the specific population you are aiming to reach. This allows the program curriculum and delivery methods to be tailored for optimal receptiveness and outcomes. Obtaining visual aids, establishing evaluation methods, and selecting modalities like computer-based education are all important secondary steps. However, identifying barriers and knowledge gaps through preliminary data collection ensures that the choice of learning aids and teaching strategies will be informed by and directly address the needs of the target group. As the first action, collecting data on potential barriers to learning about STIs among local adolescents allows subsequent program decisions to be evidence- based and population-specific. This patient-centered approach plants the seeds for successful outcomes from the start.
a nurse is counseling a client who has a new diagnosis of chlamydia. which of the following information should the nurse include in the teaching? (select all that apply)

encourage the family to join a support group
provide the family with information about respite care
educate the family regarding the progression of dementia
engage the family in informal conversation
- √√The nurse should take time to engage the family in informal conversation first (option 4). When making an initial home visit to a family providing care for a relative with dementia, the priority action is to establish rapport and trust through informal discussion before moving to targeted education or advice. Letting the family share their experiences, feelings and challenges with dementia care in an open dialogue builds crucial rapport. This enables the nurse to better understand the family's current knowledge, coping status, and self-identified learning needs to guide appropriate next steps. Providing information, encouragement and education without first listening to the family risks causing defensiveness if they feel overloaded or patronized. Option 4 lays the interpersonal foundation for effective collaborative support. Connecting with the family's situation and earning their trust facilitates receptiveness for future health promotion guidance.
a parrish nurse is counseling a family following a client's recent diagnosis of heart disease. which of the following actions should the nurse takefirst?
discuss the benefits of eating a well-balanced diet with the client's family
assist the client and the clients partner with finding an affordable exercise program
offer to accompany the client and the clients partner during health care provider visits
ask family members about the impact of the disease on relationships within the family
- √√The nurse should first ask family members about the impact of the disease on relationships within the family (option 4).

When providing counseling after a new diagnosis, the priority is to assess the client’s and family’s understanding and coping with the illness before educating or making recommendations. Heart disease affects the whole family. Asking open-ended questions allows the nurse to evaluate existing knowledge gaps, emotions, fears, denial or relationship changes that require support. This enables the subsequent teaching and assistance to be tailored at the appropriate level. Discussing diet, finding exercise programs or attending appointments should come after fully understanding the family’s perceptions and the burden caused by the diagnosis. Option 4 empowers family participation and guides the care plan. Establishing rapport and trust provides the foundation for health promotion interventions to successfully promote self-management.

a nurse is caring for a client who is having difficulty performing activities of daily living. the nurse is functioning in which of the following roles when arranging for an occupational therapist to visit the client.
Administrator
nurse consultant
case manager
clinician
- √√The nurse is functioning as a case manager (option 3) when arranging for an occupational therapist to visit the client who is having difficulty performing activities of daily living. A case manager role focuses on care coordination, which involves organizing and managing a client's total health services to achieve optimal outcomes. By referring the client to an occupational therapist due to impaired ADLs, the nurse is coordinating additional services to meet the client's needs. An administrator (option 1) oversees organizational operations at a broad level. A nurse consultant (option 2) provides expert advice. A clinician (option 4)